One biopsy was placed into the CLOtest (Clia Waived, USA) and kept at room temperature. The results were recorded as specified by the manufacturer.
Biopsies for culture were dissected into small pieces using a sterile blade and then inoculated onto Colombia agar medium (Oxoid, United Kingdom), with 5% defibrinated sheep blood and selective supplements (H pylori-selective supplement, Oxoid). The cultures were incubated in anaerobic jars, in humidified, microaerophilic conditions, using CompyGen Gas pack (Oxoid) at 37°C for five days. The organisms were identified as H pylori by Gram staining, colony morphology, and urease, oxidase and catalase-posi-tive reactions.
Antral biopsies placed in 10% formalin were sent to the histopathology laboratory. Sections were stained with hematoxylin and eosin stain, and modified Giemsa stain, and examined by an experienced histopathologist.
The ELISA-kit SIA-H pylori (Sigma, USA) was used to detect IgG antibodies to H pylori in human sera. The test was conducted according to the manufacturer’s instructions. Samples were washed with the ELx50 Auto Strip Washer, and the results were read with the ELx800 Universal Microplate Reader (Bio-Tek Inc, USA). All samples were tested at the same time.